Abstract:
A 53 years old man presented with 7 day history of arthritis affecting small joints of hands, wrist, elbow, knees and feet. He was diagnosed as a case of gout 5 years back when he suffered from acute inflammatory monoarthritis involving 1st metacarpophalangeal joint, which on aspiration showed monosodium urate crystals, and was taking allopurinol intermittently. He was also diagnosed as a case of medullary sponge kidneys and underwent pyelolithotomy 8 years back. On examination, he had arthritis of joints with skin nodules over some joints. There were tophaceous deposits in the ear lobules. Excision biopsy of skin nodule were suggestive of gout tophus. Hand radiographs showed minimal erosion with minimal juxta-articular osteopenia. Foot radiograph revealed erosive changes along with medial margin of 2nd metatarsal bone. Elbow joint radiograph revealed elevation of anteriofatpad at elbow joint which indicated the intrasynovial effusion typical of rheumatoid arthritis.
Page(s):
259-264
DOI:
DOI not available
Published:
Journal: Pakistan Armed Forces Medical Journal, Volume: 54, Issue: 2, Year: 2004